--- title: The New Summary of Benefits and Coverage (SBC) description: This article answers frequently-asked questions about the SBC and what you need to do as the employer sponsor. image: https://blog.axcethr.com/hubfs/Stock%20images/Close%20up%20image%20of%20businesswoman%20hands%20signing%20documents.jpeg --- - [Client Portal](https://www.axcethr.com/client-services/) - [Employee Login](https://www.axcethr.com/client-services/) [![AxcetHR Solutions Blog](https://blog.axcethr.com/hubfs/AxcetHR2021%20Blog/axcethr_logo_white%20(1).png)](https://www.axcethr.com/) - [About Us](https://www.axcethr.com/about-us/) - [Corporate Philantropy](https://www.axcethr.com/about-us/corporate-philanthropy/) - [Meet the Team](https://www.axcethr.com/about-us/meet-the-team/) - [Values and Culture](https://www.axcethr.com/about-us/values-and-culture/) - [Kansas PEO](https://www.axcethr.com/about-us/kansas-peo/) - [Missouri PEO](https://www.axcethr.com/about-us/missouri-peo/) - [Careers](https://axcethrsolutions.prismhr-hire.com/) - 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[Human Resources](https://blog.axcethr.com/topic/human-resources) - [Payroll Administration](https://blog.axcethr.com/topic/payroll-administration) - [Employee Safety & Risk Management](https://blog.axcethr.com/topic/employee-safety-risk-management) - [Employee Benefits](https://blog.axcethr.com/topic/employee-benefits) - [All about COVID-19 in the Workplace](https://blog.axcethr.com/topic/covid19) - [Kansas & Missouri HR News](https://blog.axcethr.com/topic/kansas-and-missouri-hr-news) - [Kansas City Interest News](https://blog.axcethr.com/topic/kansas-city-interest-news) - [PEO/HRO](https://blog.axcethr.com/topic/peo) - Choose Topic: - [Human Resources](https://blog.axcethr.com/topic/human-resources) - Payroll Administrations - [Employee Safety & Risk Management](https://blog.axcethr.com/topic/employee-safety-risk-management) - [Employee Benefits](https://blog.axcethr.com/topic/employee-benefits) - [PEO](https://blog.axcethr.com/topic/peo) # The New Summary of Benefits and Coverage (SBC) By [Jeanette Coleman, SPHR & SHRM-SCP](https://blog.axcethr.com/author/jeanette-coleman) on [Sep 12, 2017](https://blog.axcethr.com/the-new-summary-of-benefits-and-coverage-sbc) 5 min read [0 comment(s)](https://blog.axcethr.com/the-new-summary-of-benefits-and-coverage-sbc#comments-listing) Share this: - - - - [whatsapp://send?text=https://blog.axcethr.com/the-new-summary-of-benefits-and-coverage-sbc](whatsapp://send?text=https://blog.axcethr.com/the-new-summary-of-benefits-and-coverage-sbc) - [mailto:?subject=The%20New%20Summary%20of%20Benefits%20and%20Coverage%20(SBC)&body=https://blog.axcethr.com/the-new-summary-of-benefits-and-coverage-sbc](mailto:?subject=The%20New%20Summary%20of%20Benefits%20and%20Coverage%20(SBC)&body=https://blog.axcethr.com/the-new-summary-of-benefits-and-coverage-sbc) ![The New Summary of Benefits and Coverage (SBC)](https://blog.axcethr.com/hubfs/Stock%20images/Close%20up%20image%20of%20businesswoman%20hands%20signing%20documents.jpeg) As open enrollment season approaches, employers and their advisors are getting ready to use the new Summary of Benefits and Coverage (SBC) format required under federal rules. The basic rules have been in place for several years, but 2017 is the first year that health plans must use newly updated templates and instructions to create their SBCs. This article answers frequently-asked questions about the SBC and what you need to do as the employer sponsor. ## What is the Summary of Benefits and Coverage (SBC)? The Summary of Benefits and Coverage (SBC) describes the plan’s benefits and limits, provides contact information, and illustrates hypothetical coverage scenarios in a standardized format. Using templates and instructions provided by federal agencies, health insurers and employers insert case-specific information to create an SBC for their plan. See a [sample SBC.](https://www.dol.gov/agencies/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/summary-of-benefits) The SBC is sometimes called the uniform four-page summary, although it may be longer due to double-sided pages. The format requires presenting specific information in a specific order which is intended to help employees easily understand the plan’s key features and compare different plans. ## Who is responsible for the SBC? The insurance company or the employer? Group health plans are required to provide the SBC to plan participants before enrollment or re-enrollment. For plans provided through group insurance, the insurance carrier is responsible for producing the SBC and providing it to the plan administrator (employer). Both the insurer and employer are responsible for distributing the SBC to the plan participants. Either one may handle the distribution, but the employer needs to ensure it is done. For self-funded health plans, the plan sponsor (employer) is responsible for producing and distributing the SBC. Most self-funded employers choose to contract with their third-party administrator or claims administrator for this service, but the employer retains ultimate responsibility for compliance. ## Is an SBC required for every health plan? If the employer offers multiple plans, can the information be consolidated into a single SBC? An SBC generally is required for any health plan providing medical benefits, but not for plans that primarily provide excepted benefits. For example, SBCs are not required for the following: - Limited-scope stand-alone dental and/or vision plans; - Health Flexible Spending Accounts (HFSAs) with little or no employer contribution; - Fixed-indemnity or specific-disease policies; - Long-term care, disability or accident coverage; or - Retiree-only plans. A separate SBC is required for each health plan that can be chosen for enrollment. For instance, if the employer offers one PPO plan and two HMO plans, there will be three separate SBCs. A consolidated summary describing multiple plans may be helpful to employees, and may be provided in addition to the SBCs, but cannot take the place of the required SBCs. Different options within a plan can be shown on the same SBC provided the information is clear. For instance, different coverage levels (self/family) or different cost-sharing options (high deductible/low deductible) can be presented in the same SBC as long as the remainder of the coverage information is very similar. ## Is an SBC required for a Health Savings Account (HSA) or a Health Reimbursement Arrangement (HRA)? A Health Savings Account (HSA) is a savings program—not a health plan—so no SBC is required. However, a High Deductible Health Plan (HDHP), which sometimes is called an HSA-compatible plan, is a health plan requiring an SBC. Employers that contribute to their employees’ HSAs may want to show that information on the HDHP SBC. A Health Reimbursement Arrangement (HRA) is a group health plan. In almost all cases, the HRA is integrated with another plan, such as a major medical plan or HDHP. Employers usually choose to include information about HRA amounts, and how they reduce deductibles or other cost-sharing, on the medical plan SBC. ## What is the deadline for distributing the SBC? The insurer or employer must distribute the SBC at each of the following times: At the beginning of each enrollment period (i.e., when a new employee first becomes eligible to enroll and at the start of each annual open enrollment period): 1. - Within seven (7) business days of the participant’s request; and - Within 90 calendar days of a HIPAA special enrollment. ## Can the SBC be distributed electronically or are paper copies required? SBCs can be distributed electronically, provided the method complies with the DOL safe harbor for electronic delivery of benefit notices. The usual DOL guideline is a little less strict for SBCs. For instance, if enrollment is conducted exclusively online, SBCs can be provided electronically. Otherwise, for enrolled participants who use a computer as part of their regular job duties, the SBC can be sent to that computer, or it can be posted and a notice sent explaining how to access it, along with information about how to request a paper copy at no charge. For eligible participants who are not enrolled, it is sufficient to post the SBCs online as long as persons are notified of availability (see model notice above). In any case, a paper copy must be furnished upon the participant’s request. More Information For copies of the new templates, instructions, and related materials, see the following: - [Summary of Benefits and Coverage (SBC) Template](https://www.dol.gov/sites/dolgov/files/EBSA/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/sbc-template-new.pdf) | [MS Word Format](https://www.dol.gov/sites/dolgov/files/EBSA/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/sbc-template-new.docx) - [Sample Completed SBC](https://www.dol.gov/sites/dolgov/files/EBSA/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/sbc-completed-new.pdf) | [MS Word Format](https://www.dol.gov/sites/dolgov/files/EBSA/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/sbc-completed-new.docx) - [Instructions for Completing the SBC - Group Health Plan Coverage](https://www.dol.gov/sites/dolgov/files/EBSA/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/sbc-instructions-for-completing-the-group-health-plan-coverage-new.pdf) and [Consumer Assistance Programs](https://www.dol.gov/sites/dolgov/files/EBSA/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/consumer-assistance-programs.doc) - [Instructions for Completing the SBC - Individual Health Insurance Coverage](https://www.dol.gov/sites/dolgov/files/EBSA/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/sbc-instructions-for-completing-the-individual-health-insurance-coverage-new.pdf) - [Why This Matters language for "Yes" Answers](https://www.dol.gov/sites/dolgov/files/EBSA/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/sbc-why-this-matters-language-for-yes-answers-new.pdf) - [Why This Matters language for "No" Answers](https://www.dol.gov/sites/dolgov/files/EBSA/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/sbc-why-this-matters-language-for-no-answers-new.pdf) - [HHS Information For Simulating Coverage Examples](http://www.cms.gov/cciio/Resources/Forms-Reports-and-Other-Resources/index.html#Summary%20of%20Benefits%20and%20Coverage%20and%20Uniform%20Glossary) - [HHS Coverage Example Calculator and Related Information](http://www.cms.gov/cciio/Resources/Forms-Reports-and-Other-Resources/index.html#Summary%20of%20Benefits%20and%20Coverage%20and%20Uniform%20Glossary) - [List of anchors for SBC Uniform Glossary terms](https://www.dol.gov/sites/dolgov/files/EBSA/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/sbc-glossary-anchors-new.xlsx) - [Uniform Glossary of Coverage and Medical Terms](https://www.dol.gov/sites/dolgov/files/EBSA/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/sbc-uniform-glossary-of-coverage-and-medical-terms-new.pdf) - [SBC and Uniform Glossary Translations - Chinese, Spanish, Tagalog, and Navajo](https://www.cms.gov/cciio/Resources/forms-reports-and-other-resources/index.html#Summary%20of%20Benefits%20and%20Coverage%20and%20Uniform%20Glossary) In summary, employers offering group health coverage are encouraged to work with their carriers and benefit advisors to ensure that SBCs are prepared and distributed according to the federal rules. 2. ## **Ensure Compliance with SBC Requirements** Keeping up with evolving health plan disclosure rules like the Summary of Benefits and Coverage (SBC) can be a challenge—but it's one your business can't afford to overlook. Axcet HR Solutions helps small and mid-sized employers navigate benefits administration and compliance with confidence, so you can focus on your business while we handle the regulatory details. **Simplify benefits compliance with expert support.** [Explore our employee benefits administration and compliance services](https://www.axcethr.com/services/employee-benefits/employee-benefits-administration-and-compliance/) to stay compliant and keep your workforce informed. 3. [![New call-to-action](https://no-cache.hubspot.com/cta/default/2652187/7e16d9f2-75c0-482f-ae6d-407aba0aa50a.png)](https://cta-redirect.hubspot.com/cta/redirect/2652187/7e16d9f2-75c0-482f-ae6d-407aba0aa50a) [![Jeanette Coleman, SPHR & SHRM-SCP](https://blog.axcethr.com/hs-fs/hubfs/Jeanette-04.jpg?width=80&height=80&name=Jeanette-04.jpg)](https://blog.axcethr.com/author/jeanette-coleman) Written by #### [Jeanette Coleman, SPHR & SHRM-SCP](https://blog.axcethr.com/author/jeanette-coleman) Jeanette Coleman, SPHR, SHRM-SCP, is the Director of Human Resources at Axcet HR Solutions, where she has contributed her expertise for over 21 years. As a leader in the HR industry, she holds advanced certifications as a Senior Professional in Human Resources (SPHR) and SHRM-Senior Certified Professional (SHRM-SCP). Jeanette oversees HR strategy and operations, ensuring Axcet delivers exceptional HR services that help small and mid-sized businesses stay compliant and grow. With a Master’s degree in Human Resource Management from Keller Graduate School and a Bachelor of Science in Business Administration from Kansas State University, Jeanette is well-equipped to lead and support clients in navigating complex HR challenges. Throughout her 15-year tenure as Director of Human Resources, she has been instrumental in positioning Axcet as the Midwest’s largest and premier Professional Employer Organization (PEO). Her previous roles at Axcet include Director of Employee Benefits and Senior HR Consultant, where she gained extensive experience in HR outsourcing, and employee risk management. Jeanette’s expertise has been recognized through industry and regional publications. She co-authored the article “High-Touch in the Age of High-Tech: How PEOs Can Embrace AI Without Losing Their Humanity” (https://peoinsider.org/articles/high-touch-in-the-age-of-high-tech-how-peos-can-embrace-ai-without-losing-their-humanity/) for PEO Insider (March 2026), alongside Jo McClure, and was featured in Ingram’s Magazine in a Q&A (https://ingrams.com/article/qa-with-jeanette-coleman/) discussing generational change, technology, and workplace culture. These contributions reflect her perspective on balancing innovation with the human side of HR. Jeanette’s leadership reflects her deep commitment to helping businesses thrive through strategic, compliance-driven HR solutions. Through her writing, she shares insights on HR strategy, compliance, and best practices to help employers confidently manage their workforce. Published in: PEO Insider and Ingram's Read more [View all posts →](https://blog.axcethr.com/author/jeanette-coleman) ### Get HR Updates ### Table of Contents #### [Q&A: Employees who Smoke ![ Employees who Smoke](https://blog.axcethr.com/hubfs/Stock%20images/business%20man%20lighting%20a%20cigarette%20in%20a%20corporate%20environment.jpeg)](https://blog.axcethr.com/qa-employees-who-smoke) #### [![](https://blog.axcethr.com/hubfs/affordable-care-act-logo1.jpg) ACA Penalties are Still In Effect](https://blog.axcethr.com/aca-penalties-are-still-in-effect) ## Let us know what you think... ![AxcetHR Blog](https://blog.axcethr.com/hubfs/AxcetHR2021%20Blog/axcethr_logo_white%20(1).png) - [Why Axcet](https://www.axcethr.com/why-axcet/) - [What We Stand For](https://www.axcethr.com/about-us/what-we-stand-for/) - [Expertise](https://www.axcethr.com/expertise/) - [Employee Benefits](https://www.axcethr.com/services/employee-benefits/) - [Human Resources](https://www.axcethr.com/services/human-resources/) - [Payroll Services](https://www.axcethr.com/services/payroll-and-tax-administration-services/) - [Risk Management](https://www.axcethr.com/services/workers-comp-and-employee-safety-risk-management/) - [Meet the Team](https://www.axcethr.com/about-us/meet-the-team/) - [Subscribe to Latest Resources](https://www.axcethr.com/subscribe-to-the-latest-resources/) - [Resource Library](https://www.axcethr.com/expertise/resource-library/) - [\[ Client Portal \]](https://www.axcethr.com/client-services/) - - - - - Search for: Copyright © 2023 Axcet HR Solutions – Kansas City's PEO Since 1988 | [Privacy Policy](https://www.axcethr.com/privacy-policy/) | [Terms and Conditions](https://www.axcethr.com/terms-conditions/) | [**Join our Team – Careers »**](https://axcethrsolutions.prismhr-hire.com/) 10975 Grandview Drive Suite 200, Corporate Woods Building 27, Overland Park, KS 66210 | Call us: 913-383-2999 *The IRS does not endorse any particular For more information on [certified professional employer organizations](https://www.axcethr.com/why-axcet/certified-peo/), go to [www.irs.gov](https://www.irs.gov).* Remove cookies ![](https://dc.ads.linkedin.com/collect/?pid=43031&fmt=gif) ```json { "@context" : "https://schema.org", "@type" : "BlogPosting", "author" : { "@type" : "Person", "name" : "Jeanette Coleman, SPHR & SHRM-SCP", "url" : "https://blog.axcethr.com/author/jeanette-coleman" }, "dateModified" : "2025-05-07T15:41:52.039Z", "datePublished" : "2017-09-12T12:00:00.000Z", "headline" : "The New Summary of Benefits and Coverage (SBC)", "image" : [ "https://blog.axcethr.com/hubfs/Stock%20images/Close%20up%20image%20of%20businesswoman%20hands%20signing%20documents.jpeg" ], "mainEntityOfPage" : { "@id" : "https://blog.axcethr.com/the-new-summary-of-benefits-and-coverage-sbc", "@type" : "WebPage" }, "publisher" : { "@type" : "Organization", "logo" : { "@type" : "ImageObject", "url" : "https://blog.axcethr.com/hubfs/_logo_axcethr_primary.png" }, "name" : "Axcet HR Solutions" } } ``` ```json { "@context" : "https://schema.org", "@id" : "https://www.axcethr.com/#organization", "@type" : "Organization", "address" : { "@type" : "PostalAddress", "addressCountry" : "US", "addressLocality" : "Kansas City", "addressRegion" : "MO" }, "aggregateRating" : { "@type" : "AggregateRating", "bestRating" : "5", "ratingValue" : "5", "reviewCount" : "100" }, "areaServed" : { "@type" : "Country", "name" : "United States" }, "award" : [ "IRS Certified Professional Employer Organization (CPEO)", "Award-Winning HR Solutions Provider", "SHRM Certified HR Professionals", "HRCI Certified HR Professionals" ], "contactPoint" : { "@type" : "ContactPoint", "areaServed" : "US", "availableLanguage" : "English", "contactType" : "Customer Service" }, "description" : "Award-winning Professional Employer Organization (PEO) providing comprehensive HR solutions, payroll services, employee benefits, and risk management to small and mid-sized businesses. 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The basic rules have been in place for several years, but 2017 is the first year that health plans must use newly updated templates and instructions to create their SBCs. This article answers frequently-asked questions about the SBC and what you need to do as the employer sponsor. What is the Summary of Benefits and Coverage (SBC)? The Summary of Benefits and Coverage (SBC) describes the plan’s benefits and limits, provides contact information, and illustrates hypothetical coverage scenarios in a standardized format. Using templates and instructions provided by federal agencies, health insurers and employers insert case-specific information to create an SBC for their plan. See a sample SBC. The SBC is sometimes called the uniform four-page summary, although it may be longer due to double-sided pages. The format requires presenting specific information in a specific order which is intended to help employees easily understand the plan’s key features and compare different plans. Who is responsible for the SBC? The insurance company or the employer? Group health plans are required to provide the SBC to plan participants before enrollment or re-enrollment. For plans provided through group insurance, the insurance carrier is responsible for producing the SBC and providing it to the plan administrator (employer). Both the insurer and employer are responsible for distributing the SBC to the plan participants. Either one may handle the distribution, but the employer needs to ensure it is done. For self-funded health plans, the plan sponsor (employer) is responsible for producing and distributing the SBC. Most self-funded employers choose to contract with their third-party administrator or claims administrator for this service, but the employer retains ultimate responsibility for compliance. Is an SBC required for every health plan? If the employer offers multiple plans, can the information be consolidated into a single SBC? An SBC generally is required for any health plan providing medical benefits, but not for plans that primarily provide excepted benefits. For example, SBCs are not required for the following: Limited-scope stand-alone dental and/or vision plans; Health Flexible Spending Accounts (HFSAs) with little or no employer contribution; Fixed-indemnity or specific-disease policies; Long-term care, disability or accident coverage; or Retiree-only plans. A separate SBC is required for each health plan that can be chosen for enrollment. For instance, if the employer offers one PPO plan and two HMO plans, there will be three separate SBCs. A consolidated summary describing multiple plans may be helpful to employees, and may be provided in addition to the SBCs, but cannot take the place of the required SBCs. Different options within a plan can be shown on the same SBC provided the information is clear. For instance, different coverage levels (self/family) or different cost-sharing options (high deductible/low deductible) can be presented in the same SBC as long as the remainder of the coverage information is very similar. Is an SBC required for a Health Savings Account (HSA) or a Health Reimbursement Arrangement (HRA)? A Health Savings Account (HSA) is a savings program—not a health plan—so no SBC is required. However, a High Deductible Health Plan (HDHP), which sometimes is called an HSA-compatible plan, is a health plan requiring an SBC. Employers that contribute to their employees’ HSAs may want to show that information on the HDHP SBC. A Health Reimbursement Arrangement (HRA) is a group health plan. In almost all cases, the HRA is integrated with another plan, such as a major medical plan or HDHP. Employers usually choose to include information about HRA amounts, and how they reduce deductibles or other cost-sharing, on the medical plan SBC. What is the deadline for distributing the SBC? The insurer or employer must distribute the SBC at each of the following times: At the beginning of each enrollment period (i.e., when a new employee first becomes eligible to enroll and at the start of each annual open enrollment period): Within seven (7) business days of the participant’s request; and Within 90 calendar days of a HIPAA special enrollment. Can the SBC be distributed electronically or are paper copies required? SBCs can be distributed electronically, provided the method complies with the DOL safe harbor for electronic delivery of benefit notices. The usual DOL guideline is a little less strict for SBCs. For instance, if enrollment is conducted exclusively online, SBCs can be provided electronically. Otherwise, for enrolled participants who use a computer as part of their regular job duties, the SBC can be sent to that computer, or it can be posted and a notice sent explaining how to access it, along with information about how to request a paper copy at no charge. For eligible participants who are not enrolled, it is sufficient to post the SBCs online as long as persons are notified of availability (see model notice above). In any case, a paper copy must be furnished upon the participant’s request. More Information For copies of the new templates, instructions, and related materials, see the following: Summary of Benefits and Coverage (SBC) Template | MS Word Format Sample Completed SBC | MS Word Format Instructions for Completing the SBC - Group Health Plan Coverage and Consumer Assistance Programs Instructions for Completing the SBC - Individual Health Insurance Coverage Why This Matters language for "Yes" Answers Why This Matters language for "No" Answers HHS Information For Simulating Coverage Examples HHS Coverage Example Calculator and Related Information List of anchors for SBC Uniform Glossary terms Uniform Glossary of Coverage and Medical Terms SBC and Uniform Glossary Translations - Chinese, Spanish, Tagalog, and Navajo In summary, employers offering group health coverage are encouraged to work with their carriers and benefit advisors to ensure that SBCs are prepared and distributed according to the federal rules. Ensure Compliance with SBC Requirements Keeping up with evolving health plan disclosure rules like the Summary of Benefits and Coverage (SBC) can be a challenge—but it's one your business can't afford to overlook. Axcet HR Solutions helps small and mid-sized employers navigate benefits administration and compliance with confidence, so you can focus on your business while we handle the regulatory details. Simplify benefits compliance with expert support. Explore our employee benefits administration and compliance services to stay compliant and keep your workforce informed.", "author" : { "@id" : "https://blog.axcethr.com/author/jeanette-coleman#author", "@type" : "Person", "name" : "Jeanette Coleman, SPHR & SHRM-SCP", "url" : "https://blog.axcethr.com/author/jeanette-coleman" }, "dateCreated" : "2017-09-12", "dateModified" : "2025-05-07", "datePublished" : "2017-09-12", "description" : "As open enrollment season approaches, employers and their advisors are getting ready to use the new Summary of Benefits and Coverage (SBC) format required under federal rules. 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